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SBRT for Early-Stage Solitary Hepatocellular Carcinoma: A View From Australia

By: Jenna Carter, PhD
Posted: Friday, November 17, 2023

Stereotactic body radiation therapy (SBRT) has shown high rates of local tumor control in patients with hepatocellular cancer; however, there are limited data on its effects in the treatment-naive population. An article published in Clinical Oncology reported on the outcomes of patients with solitary early-stage hepatocellular cancer treated with SBRT as a first-line treatment. David Pryor, MBBS, of the University of Queensland, Australia, and colleagues reported that more than 90% of patients examined had 2 years of freedom from local disease progression. Based on these findings, the study authors concluded that SBRT may prove to be an effective and well-tolerated treatment option for this population. 

“Standard curative options for early-stage, solitary hepatocellular carcinoma… are often unsuitable due to liver dysfunction, comorbidities, and/or tumor location,” stated Dr. Pryor and colleagues.

A total of 68 treatment-naive patients were included in this multi-institutional retrospective study. Patients received a median follow-up of 20 months and underwent SBRT as definitive therapy between 2010 and 2019. The primary endpoint was freedom from local disease progression, and the secondary endpoints included progression-free survival, overall survival, rate of treatment-related clinical toxicities, and a change in Child-Pugh score of greater than 1.

Overall findings revealed an estimated 2-year freedom from local disease progression of 94.3% (95% confidence interval [CI] = 86.6%–100%). In addition, the progression-free survival rate was 59.5% (95% CI = 46.3%–76.4%), and the overall survival rate was 88% (95% CI = 79.2%–97.6%), respectively.

Toxicity analyses revealed that a total of nine patients (13.2%) experienced grade 2 or greater treatment-related clinical toxicities. Further, a rise of greater than 1 in Child-Pugh score was observed in six patients with cirrhosis (9.6%). There were also no reported grade 3 to 5 treatment-related clinical toxicities, and six patients experienced grade 2 toxicities within 3 months after treatment, the most common being fatigue (67%).

Disclosure: The study authors reported no conflicts of interest.

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